The invention relates to a surgical drainage system and more particularly to a device which is designed to drain fluids from a body cavity such as the plueral cavity and to maintain proper pressures within the body cavity.
It is essential for normal breathing that the space within the pleural cavity surrounding the lungs be free of liquid and be subject to a negative pressure so as to draw the lungs outwardly to fill the pleural cavity and permit proper breathing. Any invasion of the pleural cavity such as is caused by lung surgery or foreign objects which pierce the ribcage or where the patient has pleurisy, generate fluids in the pleural cavity which tend to obstruct normal breathing operations. It is necessary to provide a device which can remove these fluids from the pleural cavity and at the same time insure that the desired degree of negative pressure is maintained within the plerual cavity.
One of the basic types of apparatus which has been used for this purpose is shown, for example, in U.S. Pat. Nos. 3,363,626 and 3,363,627. This apparatus is known as an underwater drainage apparatus and provide three chambers, one chamber comprising a collection chamber for collecting the fluids drained from the pleural cavity through a thorocotomy tube, a second chamber known as an underwater seal chamber which protects the plerual cavity from being subject to atmospheric pressure, and a third chamber known as a pressure manometer chamber which serves to regulate the degree of negative pressure within the pleural cavity. This type of apparatus has been highly successful in both removing fluids from the pleural cavity and in maintaining the desired degree of negativity within the pleural cavity. However, such an apparatus required prefilling the underwater seal chamber with water and also prefilling the pressure manometer chamber to the desired level to maintain the desired degree of negativity within the pleural cavity. However, there has been a need for a drainage device which could be attached to the patient's pleural cavity and which did not require any prefilling, and which did not require a vacuum pump. For example, in emergency situations in the field where liquid may not be available for filling the underwater seal and manometer chambers or where a vacuum pump may not be available, it is necessary to provide a device which can be attached to a patient's pleural cavity to permit drainage of fluids to allow the lungs to expand.
The drainage system disclosed in U.S. Pat. No. 4,015,603 provided an apparatus which eliminated the need for a prefilled underwater seal chamber by locating the underwater seal at the lower end of the thorocotomy tube at the upper end of the drainage device. In the device shown in this prior patent, the underwater seal was formed by liquid drained from the patient's pleural cavity. However, the device disclosed in U.S. Pat. No. 4,015,603 required the use of a self-regulated vacuum pump and, in situations where such a pump was not available, the device shown in this prior art patent could not be utilized.
Furthermore, the location of the underwater seal chamber at the lower end of the thorocotomy tube as disclosed in U.S. Pat. No. 4,015,603 created a further problem in certain unusual circumstances. In case of a patient having a blockage in the bronchial tubes, such that the patient was having severe problems in getting air into the lungs, exceedingly high negativity was being created in the pleural cavity. Such high negativity caused the fluid in the underwater seal to be drawn upwardly through the thorocotomy tube and, if the degree of negativity was sufficiently high, it was possible for fluid to reenter the pleural cavity. This condition of fluid from the underwater seal chamber reentering the pleural cavity could cause infection or otherwise create problems for the patient. In addition, it was possible to entirely lose the seal provided by the underwater seal chamber during periods of high negativity in the pleural cavity. The loss of the water seal has the potential for serious damage in the event the suction becomes disconnected or the device is used as a two bottle system with the collection chamber open to atmosphere.
In U.S. Pat. No. 3,853,128 there is disclosed a positive pressure relief valve in a drainage apparatus having a conventional underwater seal and manometer chamber. The positive pressure relief valve is disposed between the underwater seal and manometer chambers and provides relief from high pressure surges within the collection chamber. The device disclosed in U.S. Pat. No. 3,853,128 must, however, be prefilled prior to use and does not function as a two chambered device which is usable without prefilling.